The study epiDESA2 identifies all explicit requests for euthanasia or assisted suicide expressed by the person him/herself, regardless of which professional is asked and regardless of where the request is made (primary care, health institutions, medico-social institutions including nursing home care or at home) in the Burgundy-Franche-Comté region during six months.

Start Date01 Jan 2017

Sponsor / Collaborator

Centre Hospitalier Universitaire de Besancon

[+7]

100 Clinical Results associated with Centre Hospitalier Louis Pasteur

0 Patents (Medical) associated with Centre Hospitalier Louis Pasteur

Literatures (Medical) associated with Centre Hospitalier Louis Pasteur

11 Nov 2024·European Journal of Preventive Cardiology

Prognostic impact of high-intensity lipid-lowering therapy under-prescription after acute myocardial infarction in women

Article

Author: Brunelle, F ; Beygui, F ; Gabriel, A ; Lamit, X ; Toussaint, C ; Estampes, B ; Elhadad, S ; Schultz, R ; Napporn, G ; Coulon, P ; Courdier, G ; Pailloncy, M ; Pierre-Justin, E ; Pacouret, G ; Charbonnier, B ; Houeze, F ; Ghanem, M ; Koujan, B ; Marier, J-J ; Ferrières, Jean ; Magdelaine, B ; Lucas, G ; Angoulvant, D ; Luycx Bore, A ; Baradat, G ; Bessede, G ; Dulhoste, M-N ; Duvilla, N ; Delaunay, R ; Guyon, P ; Marque, N ; Richard, C ; Dibon, O ; Berenfeld, A ; Nugue, O ; Jessen, P ; Escojido, H ; Vittrant, J ; Tremeau, G ; Bareiss, P ; Lemoine, C ; Garnier, H ; Beaufils, P ; Martelet, M ; Isaaz, K ; Perret, T ; Geslin, P ; Decourcelle, V ; Belle, L ; Bureau, G ; Mansencal, N ; Vergnouix, H ; Du Villa, N ; Hamani, D ; Silvain, J ; Monsegu, J ; De Boisgelin, X ; Virot, P ; Baudouy, M ; Harbaoui, B ; Ravan, R ; Cerisier, A ; Poitrineau, O ; Dupont, J ; Dujardin, J-J ; Dibie, A ; Carrie, D ; Sader, R ; Vahdat, B ; Souk Aloun, J ; Kaaki, A ; Wolf, J-E ; Lefevre, T ; Bourdon, J-L ; Taamallah, S ; Levy, G ; Allam, S ; Lanteme, P ; Schiele, F ; Faure, A ; Monassier, J P ; Ronteix, J-F ; Flammang, D ; Sainsous, J ; Wyart, P ; Marco, F ; Bresson, D ; Bettioui, A ; Henon, P ; Lesault, P ; Boureux, C ; Le Francois, Y ; Heiligenstein, D ; Rouault, G ; Meyer, P ; Tarragano, F ; Thourot, G ; Michel, L ; D'Amato, J ; Tron, C ; Champagnac, D ; Benamer, H ; Barragan, P ; Morice, J ; Chevalier, B ; Dadez, E ; Coco, M ; Philippe, F ; Rouselle, V ; Peycher, P ; Weber, S ; Rihani, R ; Favereau, X ; Montely, J M ; Blanchard, D ; Baborier, D ; Maupas, E ; Admant, P ; Diallo, A ; Temam, R ; Djiane, P ; Boulard, P ; Cribier, A ; Claudel, J P ; Haddad, V ; Gostine, S ; Hannebicque, G ; Brunel, P ; Godenir, J-P ; Claudon, O ; Cellarier, G ; Kerneis, Mathieu ; Coste, P ; Amor, M ; Delarche, Nicolas ; Chounet, J ; Mischke, U ; Jebai ; Sans, P ; Andriambololona, M ; Perron, J M ; Genee, O ; Durup, F ; Robin, C ; Litalien, J ; Font, M ; Allal, J ; Goburdhun, C ; Bourkaib, R ; Aliot, E ; Saadouni, E-H ; Baulleret, G ; Machecourt, J ; Hammer, L ; Doazan, J-P ; Legros, G ; Escande-Orthlieb, M ; Nait Saidi, L ; Jebai, H ; Brignon, M ; Simon, Tabassome ; Muligo, A ; Lim, P ; Lahneche ; Cressens, J-P ; Heraudeau, A ; Traisnel, G ; Chmait, A ; Parola, J-L ; Pichene, M ; Zupan Sihcus, M ; Decoulx, E ; Nallet, O ; Bardet, J ; Graux, P ; Guenot, O ; Amat, G ; Ducrocq, G ; Monnier, A ; Fayard, M ; Normand ; Galley, D ; Orion, L ; Petiteau, P Y ; Georges, Jean-Louis ; Godard, S ; Le RAY, C ; Loiselet, P ; Mossard, J-M ; Le Marrec ; Elgohary ; Ritz, B ; Joseph, T ; Convert, G ; Hanssen, M ; Soto, F ; Faure, J ; Montely, J-M ; Tissot, T-A ; Boschat, J ; Cattan, S ; Albert, F ; Milon, C ; Mteirek, M ; Rougier, P ; Leclercq, F ; Quiret, J-C ; Berland, J ; Carette, B ; Salengro, E ; Gauffre, O ; Drouet, Elodie ; Jullien, T ; Sivery, B ; Raoux, F ; Pilliere, R ; Marchand, S ; Kirkorian, G ; Lucke, V ; Fonseca, E ; Ponsonnaille, J ; Charbonnel, C ; Labeque, J ; Probst, V ; Gueret, P ; Lagorce, P ; Rumeau, P ; Jambert, H ; Chaussard, C ; Halary, J-J ; Oltean, I ; Wiedemann, J Y ; Saint-Pierre, F ; Marcon, J-L ; El Moujahid, M ; Ribier, A ; Fajadet, J ; Belhassane, A ; Dujardin, J J ; Metzger, J-P ; Beaudet, B ; Richard, P ; Delarche, N ; Asseman, P ; Godreuil, C ; Ledon, S ; Pruvost, P ; Mayaud, N ; Cazaux, S ; Kadri, A ; Hidoud, A ; Moulin, F ; Rosak, P ; Ley, N ; Lucke Simandoux, V ; Koegler, A ; Bonnet, P ; Boutaud, P ; Banos, J-L ; Tea, Victoria ; Soto, F-X ; Baixas, C ; Haas, J ; Breut, C ; Bineau-Jorisse, A ; Grison, D ; Dumessi, K ; Coz, E ; Castellant, P ; Gommeaux, A ; Elkaim, J P ; Chevalevreau, P ; Cazenave, P ; Soto, F X ; Deslandes, Y ; Kahn, J-C ; Flork, L ; Coeurderoy, A ; Guerin, Y ; Coisne, D ; Delcoux, E ; Hochart, P ; Maillard, L ; Mabo, P ; Casteigt, F ; Roynard, J ; Destrac, S ; Dib, J C ; Jouve, B ; Magnin, D ; Mihoubi, A ; Fromage, P ; Demichelli, T ; Peltier, B ; Bassand, J-P ; Puymirat, Etienne ; Schmutz, L ; Salva, P ; Thisse, J-Y ; Albert, Franck ; Hauguel-Moreau, Marie ; Maes, D ; Ben AMER, H ; Le BRIS, H ; Hueber, A ; Grossetete, R ; Fourdilis, M ; Farhat, A ; Lancelin, B ; Gasmi, M ; Paemelaere, J-M ; Khanoyan, P ; Bouriche, F ; Dupouy, P ; Demicheli, T ; Mettauer, B ; Armengaud, J ; Beard, T ; Taldir, G ; Cayla, G ; Quandalle, P ; Beruben, E ; Bonnet, J L ; Dambrine, P ; Jabourek, O ; Plastaras, P ; Grentzinger, A ; Verdun, A ; Megbemado, R ; Baala, B ; Poulard, J-E ; Boccara, A ; Baciulescu, L ; Bickert, P ; De Labriole, A ; Digne, F ; Tissot, M ; Mailler, J-P ; Poulard, J E ; Banos, J L ; Weizman, Orianne ; Elaerts, J ; Khalife, K ; Henry, P ; Druelles, P ; Faure, E ; Darchis, J ; Demarcq, J M ; Meurice, T ; Marchand, X ; Andrieu, S ; Zabel, A ; Heroguelle, V ; Lapeyre, G ; Dutoit, L ; Farah, B ; Olive ; Herce, B ; Bernard, P ; Tabone, X ; Lardoux, H ; Haddad, Z ; Bontemps, T ; Chayeb, S ; Dentan, G ; Bataille, Vincent ; Gully, C ; Karsenty, B ; Godenir, J P ; Berthier, R ; Collet, J P ; Barnay, C ; Faverau, X ; Schwob, J ; Mycinski, C ; Herve, B ; Fourrier, J L ; Laurent, Y ; Darremont, O ; Saadouni, H ; Varenne, O ; Fournier, P ; Saal, J ; Champin, S ; Ferrari, E ; Vanzetto, G ; Hugon, J P ; Viallet, M ; Jellouli, B ; Meimoun, P ; Kamal, H ; Ray, J P ; Perrot, S ; Grebet, J ; Lefrancois, Y ; Cazaux, P ; Le Ray, C ; Genet, L ; Remy, J ; Walylo, F ; Lassabe, A ; Leborgne, L ; Cohen, A ; Pagny, J-Y ; Bert-Marcaz, P ; Coupillaud, J ; Petiteau, P ; Bienvenu, M P ; Vahanian, A ; Pacaud, D ; Brasselet, C ; Puel, J ; Michel, P-L ; Thisse, J Y ; Tchtchoua, D ; Airaud, P ; Pon-Gabrielsen, P ; Jarnier, P ; Rebuffat, G ; Allard-Latour, G ; Monassier, J-P ; Dewilde, J ; Halary, J J ; Saouli, D ; Rioux, P ; Guillot, J-P ; Schiele, François ; Danchin, N ; Joly, P ; Poulos, N ; Pernes, J-M ; Deturck, R ; Aboyans, V ; Cornec, P ; Vilarem, D ; Duclos, F ; Breton, C ; Poyet, R ; Zaehringer, M ; Landel, J ; Ballout, J ; Bouvier, J-M ; Werquin, S ; Huguet, R-G ; Dubourg, O ; Jullien, J ; Benderbous, R ; Bouvier, J ; Souk-Aloun, J ; Bodart, J C ; Laine, M ; Gosselin, G ; Gueniche, C ; Blanc, J-J ; Aouate, P ; Bourdon, J L ; Faure, J P ; Ledain, L ; Boueri, Z ; Cardinaud, P ; Coatantiec, G ; Paganelli, F ; Grollier, G ; Cottin, Y ; Furber, A ; Bernasconi, F ; Ettori, J ; Schiano, P ; Laurent, I ; De Breyne, B ; Baudouy, P ; Aelion, H ; Funck, F ; Motreff, P ; Francoual, M ; Carlioz ; Lang, M ; Elbaz, M ; Pochmalicki, G ; Sultan, P ; Popovic, B ; Sarfati, L ; Luycx-Bore, A ; Valy, Y ; Onceanu, S ; Roynard, J L ; Danchin, Nicolas ; D'Hautefeuille, B ; De Poli, F ; Eymerit, P ; Assayag, P ; Beauverger, Y-M ; Messner-Pellenc, P ; Moussa, K ; Levai, L ; Ohlmann, P ; Deltreuil, M ; Maillier, B ; Valeix, B ; Descotes-Genon, V ; Broucqsault, D ; Marcaggi, X ; Jarry, G ; Slama, M ; Rouffaud, J ; Palcoux, M-C ; Tran ; Bonneau, A ; Brunel, H-P ; Tibi, T ; Greciano, S ; Lantelme, P ; Leurent, G ; Scemama, A ; De Tauriac, O ; Sedighian, S ; Lemesle, G ; Cador, R ; Roche, R ; Fichter, P ; Rondepierre, D ; Allard Latour, G ; Lognogne, T ; Becquart, J ; Huret, B ; Somody, E ; Barragan, Paul ; Bazin, P ; Lescure, M ; Thieuleux, F ; Roul, G

AbstractAimsWomen are less likely to receive lipid-lowering therapy (LLT) after acute myocardial infarction (AMI). We analysed whether this under-prescription currently persists and has an impact on long-term outcomes.Methods and resultsThe FAST-MI programme consists of nationwide registries including all patients admitted for AMI ≤ 48 h from onset over a 1 month period in 2005, 2010, and 2015, with long-term follow-up. This analysis focused on high-intensity LLT (atorvastatin ≥ 40 mg or equivalent, or any combination of statin and ezetimibe) in women and men. Women accounted for 28% (N = 3547) of the 12 659 patients. At discharge, high-intensity LLT was significantly less prescribed in women [54 vs. 68% in men, P < 0.001, adjusted odds ratio (OR) 0.78(95% confidence interval (CI) 0.71–0.87)], a trend that did not improve over time: 2005, 25 vs. 35% (P = 0.14); 2010, 66 vs. 79% (P < 0.001); 2015, 67 vs. 79.5% (P = 0.001). In contrast, female sex was not associated with a lack of other recommended treatments at discharge: beta-blockers [adjusted OR 0.98(95% CI 0.88–1.10), P = 0.78], or renin–angiotensin blockers [adjusted OR 0.94(95% CI 0.85–1.03), P = 0.18]. High-intensity LLT at discharge was significantly associated with improved 5 year survival and infarct- and stroke-free survival in women [adjusted hazard ratios (HR) 0.74(95% CI 0.64–0.86), P < 0.001 and adjusted HR: 0.81(95% CI: 0.74–0.89); P < 0.001, respectively]. Similar results were found using a propensity score-matched analysis [HR for 5 year survival in women with high-intensity LLT: 0.82(95% CI 0.70–0.98), P = 0.03].ConclusionWomen suffer from a bias regarding the prescription of high-intensity LLT after AMI, which did not attenuate between 2005 and 2015, with potential consequences on both survival and risk of cardiovascular events.

05 Nov 2024·Blood

Cold Autoimmune Hemolytic Anemia Secondary to Mycoplasma Pneumoniae Infection in Adults: Results from a Large French Observational Study (MYCOLD study)

Author: Viguier, Clément ; Amarsy, Rishma ; Audia, Sylvain ; Mahevas, Matthieu ; Valentin, Simon ; Lecapitaine, Anne-Lise ; Rolland, Simon ; Comont, Thibault ; Kaueffer, Charlotte ; Luque Paz, David ; Chopin, Dorothée ; Perpoint, Thomas ; Michel, Marc ; Durand, Pauline ; Blanckaert, Karine ; Terriou, Louis ; Crickx, Etienne ; Holub, Matthieu ; Pagis, Valentine ; Coeffier, Marine ; Clément, Mélissa ; Lemoal, Gwenael ; Barret, Amaury ; Palich, Romain ; Lassel, Ludovic ; Godot, Amélie ; Leautez, Sophie ; Merindol, Julie ; Martinot, Martin ; Baltes, Virginie ; Godeau, Bertrand ; Mrozek, Natacha ; Kahn, Jean-Emmanuel ; Viallard, Jean-Francois ; Deshayes, Samuel ; De Monteynard, Soline ; Hamrouni, Sarra ; Arnould, Bérangère ; Ebbo, Mikael ; Haioun, Corinne ; Chevalier, Kevin ; Declerck, Charles

IntroductionMycoplasma pneumoniae (MP) is mostly responsible for infections of the lower respiratory tract but can also be associated with extrapulmonary manifestations, including cold antibody autoimmune hemolytic anemia (cAIHA). While the detection of cold agglutinins (CA) is relatively common in MP infection, symptomatic and/or severe forms of cAIHA are rare in this context. This association is poorly described in the literature as no large series of patients have been reported so far. The outbreak of MP infections that occurred in Northern Europe and France during last fall and winter gave rise to an unusual number of MP-associated cAIHAs. The aim of this study were to better describe the characteristics, the management and outcome of patients diagnosed with MP-associated cAIHA. and to assess the usefulness of glucocorticoids (GC) in this setting.Patients and MethodsWe conducted an ambispective (retrospective and prospective), observational, multicenter, national study. Patients were recruited by i) call for observations throughout the network of the French national society of internal medicine (SNFMI) and the French reference center for autoimmune cytopenias (CERECAI) and ii) identification of cases included in the MYCADO study (a large national multicenter observational study of MP infections). To be included, patients had to be 18 years of age or older, have a confirmed MP infection requiring hospitalization associated with cAIHA, with a nadir hemoglobin (Hb) level < 10 g/dL and a positive direct antiglobulin test with a C3d pattern.ResultsIn total, 50 patients (50% of females, with a median age [IQR] of 47 [38.5-63.5] years) at diagnosis were included. Of these, 24 (48%) had risk factors for respiratory infection (active smoking in 16 (32%) patients, asthma in 6 (12%) others), 21 (42%) had cardiovascular risk factors (hypertension, diabetes, dyslipidemia, or obesity), 4 (8%) had a history of malignant hemopathy, and 4 (8%) patients were immunocompromised. Forty-eight (96%) patients had respiratory signs related to MP infection, 20 (40%) had gastrointestinal manifestations (31.3%), 14/40 (35%) had “dark” urine and 1 (2%) had acrocyanosis. Eight (16%) patients had venous thromboembolism (including pulmonary embolism in 7 (14%)) and 22 (44%) had to be admitted in intensive care unit.The median Hb level at cAIHA diagnosis was 7 [5.9-9.8] g/dL, with a median reticulocytes count of 90 [60-144] x 109/L, and median LDH, haptoglobin, and undirect bilirubin levels of respectively 676 [470-1358] IU/L, 0 [0-0.38] g/L and 16 [7.7-51] μmol/L. Thirty-nine (78%) patients required red blood cell (RBC) transfusions, with a mean of 3 packed RBC/patient. Nineteen (38%) patients received one or more treatments “specifically” for AIHA, including GC in 14 (25%) cases and erythropoietin in 4 (8%). All patients received antibiotics, mostly macrolides (92% of the patients) for treating MP infectionMP infection resolved completely without sequelae in 43/50 (86%) cases. After a mean follow-up of 54 [27-80] days after cAIHA onset, 39/47 (83%) patients were in complete remission (defined by a stable Hb level beyond 10 g/dL off therapy), 6 (12.7%) in partial remission (defined by an increase of at least 2 g/dL of the Hb level from baseline but below 10 g/dL) and 2 (4%) patients died (one from septic shock secondary and one from pulmonary embolism).When we compared patients who did not receive any “specific” treatment for AIHA other than antibiotic ± transfusion (n=31, 62%) with those treated with GC alone (n=14, 28%), we found that patients with GC had more severe cAIHA with a lower Hb nadir (6.4 [5.9-7.4] vs. 5 [5.7-5.9] g/dl, p=0.001), a greater number of packed RBC transfused (2 [0-2] vs. 1.25 [3.5-4.75], p=0.03), and a lower rate of complete remission of cAIHA (4/14 (28.6%) vs. (26/28 (92.9%), p=0.02). However, GC did not appear to improve neither the outcome nor the time to Hb normalization in patients with MP -associated cAIHA.ConclusionThese data show that cAIHA associated with MP infection is not exceptional; and that although being often initially severe, with a high rate of venous thrombotic events, it has a good prognosis and recovers (either spontaneously or after transfusion) within few weeks in parallel with the bacterial infection. Based on our study, there is no evidence suggesting that GC, which were used for the management of the most severe cases, are helpful in this setting for reducing the duration of cAIHA.

01 Jun 2024·Archives of Cardiovascular Diseases

Rationale and design of the FRENch CoHort of myocardial Infarction Evaluation (FRENCHIE) study

Article

Author: Ferrari, Emile ; Cayla, Guillaume ; Danchin, Nicolas ; Gallet, Romain ; Gourmelen, Julie ; Dubreuil, Olivier ; Goube, Pascal ; Steg, Philippe Gabriel ; Thuaire, Christophe ; Ravaud, Philippe ; Gautier, Alexandre ; Coste, Pierre ; Durand-Zaleski, Isabelle ; Eltchaninoff, Hélène ; Popovic, Batric ; Prunier, Fabrice ; Ducrocq, Gregory ; Paganelli, Franck ; Vanzetto, Gérald ; Rousseau, Alexandra ; Cottin, Yves ; Lhermusier, Thibault ; Aboyans, Victor ; Angoulvant, Denis ; Silvain, Johanne ; Bouleti, Claire ; Dillinger, Jean-Guillaume ; Simon, Tabassome ; Schiele, François ; Lemesle, Gilles

BACKGROUNDDespite major advances in prevention and treatment, cardiovascular diseases - particularly acute myocardial infarction - remain a leading cause of death worldwide and in France. Collecting contemporary data about the characteristics, management and outcomes of patients with acute myocardial infarction in France is important.AIMSThe main objectives are to describe baseline characteristics, contemporary management, in-hospital and long-term outcomes of patients with acute myocardial infarction hospitalized in tertiary care centres in France; secondary objectives are to investigate determinants of prognosis (including periodontal disease and sleep-disordered breathing), to identify gaps between evidence-based recommendations and management and to assess medical care costs for the index hospitalization and during the follow-up period.METHODSFRENCHIE (FRENch CoHort of myocardial Infarction Evaluation) is an ongoing prospective multicentre observational study (ClinicalTrials.gov Identifier: NCT04050956) enrolling more than 19,000 patients hospitalized for acute myocardial infarction with onset of symptoms within 48hours in 35 participating centres in France since March 2019. Main exclusion criteria are age<18 years, lack of health coverage and procedure-related myocardial infarction (types 4a and 5). Detailed information was collected prospectively, starting at admission, including demographic data, risk factors, medical history and treatments, initial management, with prehospital care pathways and medication doses, and outcomes until hospital discharge. The follow-up period (up to 20 years for each patient) is ensured by linking with the French national health database (Système national des données de santé), and includes information on death, hospital admissions, major clinical events, healthcare consumption (including drug reimbursement) and total healthcare costs. FRENCHIE is also used as a platform for cohort-nested studies - currently three randomized trials and two observational studies.CONCLUSIONSThis nationwide large contemporary cohort with very long-term follow-up will improve knowledge about acute myocardial infarction management and outcomes in France, and provide a useful platform for nested studies and trials.

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